Communicable Disease Summary. a Guide for Schools and Daycares

Transcription

1 Communicable Disease Summary a Guide for Schools and Daycares

2 CAMPYLOBACTER* 2 to 5 days with Diarrhea, cramps, fever, Ingestion of undercooked Through the course of Emphasis on good hand washing. Notify PH if outbreak is a range of 1-10 and vomiting; diarrhea chicken and pork, infection (usually several Exclude symptomatic persons suspected. days. may be bloody. contaminated food and days to several weeks). from school until diarrhea/vomiting water or raw milk. has ceased. CHICKENPOX 10 to 21 days, Sudden onset of slight Person-to-person by Usually 1 to 2 days Exclude case until all blisters Babies exposed when less (Varicella) usually 13 to 17 fever and skin rash direct contact, airborne before onset of rash are dry and crusted. Pregnant than 2 days old to mothers days. consisting of small spread of respiratory to 5 days after the first women exposed to with varicella and persons blisters lasting 3 to 4 secretions; indirectly crop of blisters. chickenpox or shingles should with immunodeficiency may days that develop into through contact with consult with their doctor. No suffer severe or fatal crusts which last about articles freshly soiled exclusion for shingles if chickenpox. Shingles 14 days. The eruptions with secretions from lesions can be covered until (herpes zoster) is a come out in crops, so nose, throat, and skin crusted. "High risk" persons reactivation of the same there may be pimples, lesions. The fluid from exposed to chickenpox may virus. Varicella vaccine is blisters, and scabs the blisters is infective; need VZIG. required for new child care present at the same scabs are not. enrollees born on or after time. 9/15/97 and will be required for school entry children without a history of natural disease beginning with Pre-K in September COMMON COLD 12 to 72 hours, Runny nose, watery Person-to-person by Variable, depending on Routine exclusion is not Rhinoviruses and usually 2 days. eyes, sneezing, chills, direct contact or cause; average is 7 to recommended. Stress corona viruses are the major sore throat, cough, airborne droplets; 10 days. personal hygiene, e.g., known viral cause of colds and general body indirect contact with cover mouth and nose when in adults. Cold-like illnesses discomfort lasting 2 to articles freshly soiled coughing/sneezing; practice in infants and children are 7 days. Fever is with secretions from sanitary disposal of caused by viruses such as uncommon in nose and throat of an discharges from mouth and Para influenza, RSV, children 3 & rare in infected person. nose; encourage frequent influenza, and adenoviruses. adults. hand washing; etc. Cerro Gordo County Department of Public Health (641) Page 1

3 CONJUNCTIVITIS Usually Pink or red conjunctiva Respiratory or conjunc- During the course of If cause of conjunctivitis is Educate family and classmates (Pink eye) hours. with white or yellow tival secretions via active infection. infectious, persons should not on prevention of spread by eye discharge, often person-to-person attend school during the acute practicing good handwashing with matted eyelids contact; direct contact stage. Practice frequent hand and not sharing towels. after sleep; eye pain; through contamination washing and hygiene. swelling or redness of of the hands; contact the eyelids or skin with articles soiled with around the eye. secretions from the nose and throat of an infected person, e.g., shared towels; rarely via contaminated swimming pools. COXSACKIE Usually 3-5 days Fever, sore throat, Direct contact with During acute stage Give careful attention to prompt Educate families, teachers, and VIRUS small lesions or sores nose and throat of illness. handwashing when handling children about handwashing. (Hand, foot, & in mouth, hands, discharges and feces discharges, feces, and soiled mouth disease) & feet. of an infected person. articles. DIARRHEAL Varies Loose stools (diarrhea) Person-to-person Varies depending on Emphasize thorough When 2 or more children in DISEASES/ depending on which may be contact, often by causative agent. handwashing by children and the same classroom have GASTRO- causative agent. accompianed by fecal contamination; by staff after using the toilet, before diarrhea, either known or ENTERITIS vomiting, nausea, ingestion of food or eating, and preparing food. presumed to be of the same (see specific abdominal cramps, water contaminated Anyone ill with diarrhea, fever, or etiology, notify the local health diseases listed) or fever. May have with bacteria, viruses, vomiting should not attend school. department. Single cases of blood in stools. or parasites, e.g., food Salmonella, Shigella, E. Coli poisoning. O157:H7 infections, and all outbreaks are reportable.* DIPHTHERIA 2 to 5 days, Patches of grayish Person-to-person Up to 2 weeks if Exclude until case has 2 Prevent with immunization. occasionally membrane with contact with untreated. negative cultures for Immunize with DTaP or DTP: longer. surrounding redness of respiratory secretions Corynebacterium diphtheriae 4 doses (primary series) by throat, tonsils, larynx, or skin lesions of 24 hours apart. Culture close 16 months of age with a nose, other mucous cases or carriers. contacts; give antibiotics and booster at 4 to 6 years; Td membranes, or skin. vaccine. Exclude culture vaccine for children age 7 Mild cases are often positive contacts from food years and above, and every confused with simple handling or child care/school 10 years for adults. tonsillitis. until cultures are negative. Diphtheria vaccine is required for child care and school attendance. Cerro Gordo County Department of Public Health (641) Page 2

4 E. COLI 2 to 8 days with Severe diarrhea that Ingestion of contaminated Duration of excretion of Emphasis on good hand washing. Usually little or no fever is 0157:H7* a median of is often bloody, foods, directly person to the pathogen in the stool, Symptomatic persons should be present. More common in 3-4 days. abdominal pain, and person by the fecal-oral usually one to three excluded from school while children >4 years. vomiting. route, or contact with weeks after symptoms having diarrhea or vomiting. infected animals. begin. FIFTH DISEASE 4 to 20 days. Red, patchy facial rash Contact with Before onset of rash in Exclusion of case is not Approximately half of adults (Erythema (giving a "slapped respiratory secretions most cases; probably recommended. Those likely to in the U.S. have had fifth Infectiosum) cheek" appearance) of an infected person; not communicable after develop complications disease and are immune for that may spread to the by contaminated blood onset of rash. (persons with chronic life. Pregnant women and rest of the body in a or blood products; hemolytic anemia or persons likely to develop lace-like pattern. Rash from an infected mother immunodeficiency, and complications should consult may be preceded by to fetus. non-immune pregnant women) with a physician if exposed. cold-like symptoms. In should be informed but not Handwashing is important. adults, joint pains or routinely excluded from arthritis are likely. About settings where fifth disease 25% of cases are is occurring. Persons with asymptomatic. aplastic crises should be excluded until cleared by a physician. GIARDIA* 3-25 days or Acute or chronic Person to person The entire period of Emphasis on good hand washing. Contact public health if an longer; diarrhea, transmission, especially in infection, often months. Antiparasitic drugs are available outbreak is suspected. median 7-10 flatulence, bloating. daycare centers. Also for treatment. Treatment of days. through contaminated asymptomatic carriers is not water. necessary. Haemophilus Unknown; may This bacteria can cause Contact with discharges Until 24 hours after Exclude case until 24 hours Hib vaccine series is Influenzae type b be 2 to 4 days. a variety of symptoms or droplets from the nose effective antibiotic after start of antibiotic treatment. recommended for children (Hib) DISEASE depending on the site of or throat of an infected treatment. If untreated, Household and child care from 2 months of age until 5. infection such as ear, person; by direct person during the course of contacts may need an antibiotic Hib vaccine is required for eye, skin, joint, and to person contact. active infection. to prevent Hib disease, but do child care and pre-school; not blood infections, not need to be excluded. Contact required for school (grades pneumonia, and local health department regarding K-12). meningitis. need for prophylaxis. Cerro Gordo County Department of Public Health (641) Page 3

5 HEPATITIS A* 15 to 50 days, Jaundice, dark urine, Person-to-person by 2 weeks before to 1 Enteric precautions during first The infection may be spread usually 28 to 30 loss of appetite, nausea, fecal-oral spread; by week after onset of 2 weeks of illness. Immune asymptomatically among days. fatigue, abdominal ingestion of contaminated jaundice. globulin (IG) given to close children and only become discomfort, and fever. food or water. contacts within 2 weeks of evident when parents and No symptoms or mild exposure may protect for 5 to 8 teachers become cases. symptoms without months. Hand washing after Hepatitis A vaccine will jaundice may occur in using the toilet, and before eating protect against getting most children less than and preparing food is necessary disease. 2 years old and some to prevent and control outbreaks. adult cases. HEPATITIS B* Usually Insidious onset with dark Person-to-person Communicability: majority Routine exclusion is not Hepatitis B vaccine (3 doses) days, average urine, fatigue, loss of through sexual contact; of infected persons will recommended. Practice standard is indicated for all babies and days. appetite, nausea, exposure to infected be non-infectious within infection control precautions. for anywho who may have vomiting, sometimes blood or bodily fluids; 46 months after acute Non-immune persons exposed blood exposure or who had joint pain, and often from the mother to infant infection. 10% of adults to HBsAg positive blood should routine contact with a case followed by jaundice. during pregnancy or and 90% of infants will be given hepatitis B immune or carrier, including household Some cases are mild. birth. become chronic carriers globulin (HBIG) and vaccine. and sexual contacts of The infection may be and will be infectious the carrier. Hepatitis B vaccine asymptomatic, rest of their lives. is required for children born especially in children. after July 1, 1994 and prior to enrollment in school. HERPES SIMPLEX 2 to 12 days. Oral herpes: sores or Direct contact with As long as the sores or Routine exclusion is not Pregnant women with VIRUS blisters on the lips or saliva, sores, or blisters blisters are present, recommended. Exclude from herpes should consult with (Cold Sores, mouth. such as through about 1 to 2 weeks. child care only those children with their doctor. Fever Blisters) Genital herpes: sores touching, kissing, or Viral shedding may first time herpes of the mouth, or blisters in the genital having sex; from mother occur in the absence of i.e., primary gingivostomatitis, area. to infant during delivery, symptoms. who do not have control of less common during their secretions (drooling). pregnancy and Avoid kissing, contact with postpartum. saliva, or other direct contact with sores or blisters. Use gloves if touching lesions. Wash hands well. If possible, cover active lesions with clothing, bandage, or appropriate dressing. Cerro Gordo County Department of Public Health (641) Page 4

6 HIV (Human Variable. The HIV infection may be Person-to-person Throughout the life of Routine exclusion is not Supplies needed to Immunodeficiency commonly used asymptomatic for many through sexual contact; an infected individual. recommended. Educate on how implement standard Virus) Infection* HIV antibody years. Symptoms in later exposure to HIV-infected to prevent HIV transmission; infection control (includes AIDS*) tests will detect stages are variable, blood, e.g., dirty needles: use standard infection control precautions, including infection in most depending on from mother to infant precautions to avoid exposure gloves and appropriate people within 6 opportunistic infections. during pregnancy or to blood or any body fluid except disinfectant cleaners, to 12 weeks birth. sweat. must be available. after infection. IMPETIGO 4 to 10 days. Blister-like lesions Direct contact with From onset of symptoms Exclude until 24 hours after All persons with lesions which later develop into draining sores. Less until sores are healed. start of antibiotic treatment. should avoid contact with crusted sores which commonly by touching Topical treatment and/or newborn babies. are irregular in outline. articles contaminated antibiotics needed; cover lesions. Usually caused by with the blister fluid. Hand washing by caretakers Staphylococcus aureus reduces transmission. Infected and Streptococcus individuals should use separate pyogenes. towels and washcloths. INFLUENZA Usually 1-3 Fever, cough, Airborne; spread from an 3-5 days from clinical Persons who are ill with fever & Vaccine is available for 6 days. headache, muscle infected person usually onset in adult, up to 7 cough should stay home. Cover months through adulthood. aches & fatigue. through coughing and days in young children. mouth and nose when coughing Vaccine needs to be sneezing. or sneezing. Use good repeated each year to cover handwashing practices. the appropriate strains for that flu season. LYME DISEASE* 3 to 32 days. A distinctive skin lesion By bite of an infected (No documented Routine exclusion is not Treatment with antibiotics to (Typically appears as a red spot or deer tick that has been person-to-person or recommended. Avoid exposure prevent complications should 7-14 days) bump which expands to left attached for 24 hours vertebrate animal-to- to deer ticks; when outdoors, start upon suspected greater than 2 inches, or more. person spread.) wear protective clothing, use diagnosis (based on history with malaise, fatigue, repellants, inspect entire body of tick exposure and clinical fever, headache, stiff every 3-4 hours, and promptly signs and symptoms). neck, joint pain for remove attached ticks. If tick bite Prophylactic administration several weeks. Neuro- occurs, record date and body of antibiotic is not usually logic, cardiac, or arthritic site and save tick. Consult recommended. complications may physician if skin rash or early follow. symptoms occur. Cerro Gordo County Department of Public Health (641) Page 5

7 MEASLES 7 to 18 days, Sudden onset of chills, Droplet spread or direct 4 days before to 4 days Exclude case for at least 4 days Very communicable. (Rubeola) usually 10 days followed by sneezing, contact with throat of after the rash appears. after onset of rash. Susceptible Immunize all children from exposure to running nose, conjunc- nasal secretions of an contacts may be protected if routinely at 12 months of age onset of fever, tivitis, photophobia, infected person. vaccine is given within 72 hours with MMR (measles-mumpsand usually 14 fever, and cough. The of exposure, or immune globulin rubella) vaccine. Measles days from rash, seen about 2 to 7 within 6 days of exposure. After vaccine is required for child exposure to days later, usually exposure, exclude susceptibles care and preschool; second onset of rash. appears first behind the from school or child care until dose of measles vaccine is ears or on the forehead approved to return by health required for all children in and face; it is blotchy department. Pregnant women grades K-12 and for preand usually dusky red should check with their doctor schoolers exposed to and spreads rapidly over if exposed. measles cases. the face, trunk, and limbs. Small white spots (Koplik spots) may appear inside the mouth. MENINGOCOCCAL 2 to 10 days, Sudden onset with Close contact with Asymptomatic carriers Case needs antibiotics. Exclude Vaccine is now available for DISEASE usually 3 to 4 fever, vomiting, droplets and discharge are common until case for 24 hours after start of certain types of meningococdays. intense headache, and from nose or throat of meningococci are no antibiotic treatment. A prophylactic cal disease and can be used stiffness of the neck. an infected person. longer present in antibiotic is recommended for in outbreaks. Small bright red spots discharges from nose household, child care contacts, Invasive meningococcal may appear on the and mouth, usually within and others with saliva contact, disease is an emergency body. 24 hours after start e.g., kissing, CPR. Contacts reportable disease to local of chemotherapy. should watch for symptoms for and state public health 2 weeks and should seek departments. immediate medical attention if ill. MONONUCLEOSIS 4 to 6 weeks. Fever, swollen glands, Person-to-person contact Prolonged; the virus that Avoid drinking or eating after Patients with a recent fatigue that lasts of saliva of an infected is carried in the throat an infected person. diagnosis of mono infection several weeks. person, occasionally by during the illness can should not donate blood. a blood transfusion. be present for as long as a year. Cerro Gordo County Department of Public Health (641) Page 6

8 METHICILLIN Extremely Person-to-person by Skin or respiratory As long as infection or Proper handwashing and basic Students colonized with MRSA RESISTANT variable. direct contact. secretions. colonization lasts. infection control measures are should not be excluded from STAPHYLOCOCCUS Persons that have the most important measure to school. If infection is present AURUES draining infections are prevent the spread of MRSA. and child needs to attend (MRSA) shedding more bacteria daycare/school, following than someone that is standard precautions and use only colonized. of barrier methods to prevent exposure to secretions will assist in preventing transmission. MUMPS* 14 to 25 days, Fever, swelling, and Airborne transmission From 6 days before Exclude case for 9 days after Very communicable. (Infectious usually 18 days. tenderness of the of droplets from an salivary gland onset of swelling. A live Immunize all children Parotitis) salivary gland; may be infected person's nose enlargement to 9 days attenuated virus vaccine is routinely at 12 months with asymptomatic. The or throat. after. available alone or combined with MMR vaccine. Mumps vaccine parotid glands in front of measles and rubella vaccines is required for child care and and below the ears are (MMR). Pregnant women should school attendance. most frequently affected. check with their doctor if Meningitis may occur. In exposed. Follow health post pubertal males, department recommendations for involvement of the testes exclusion of susceptible contacts. may occur. NORWALK VIRUS/ Usually Nausea with vomiting, Contaminated food and During acute stage or Proper handwashing is very Illness usually lasts NOROVIRUS hours. diarrhea and cramps. water. Also spread from disease up to 48 hours important. Anyone having hours without any long ("Stomach flu", May also experience person to person after diarrhea stops. diarrhea, fever, or vomiting should term effects. Contact PH if an viral gastroenteritis) headache, fever, chills, fecal-oral. not attend school. outbreak suspected. and muscle aches. PEDICULOSIS Eggs (nits) of Asymptomatic, or itching Direct contact with Communicable while Treat case with medicated shampoo Common in school-age (Head Lice) lice hatch into of the scalp. Nits are infested persons, or lice remain alive on or medicated crème rinse (pediculicide). children. The head louse nymphs in a tightly attached to the contact with their infested person or on Launder (using hot cycles of washer and does not transmit any week; nymphs shaft of the hair close to clothing, combs, brushes, clothing, and until eggs dryer) or dry clean clothes and bedding. communicable disease. It is become sexually the scalp; crawling lice carpets, or linens. Lice (nits) have been Case may return to child care or school important that the mature, mate, can be seen most generally die when away destroyed. the morning after treatment. manufacturer's and lay eggs in commonly at the nape of from a host for more than Retreatment in 7 days may be needed. recommendations regarding 8 to 10 days the neck and behind the 48 hours. Contacts should be examined and treatment be followed, and after hatching. ears. treated also. that nits be removed. Cerro Gordo County Department of Public Health (641) Page 7

9 PERTUSSIS* 6 to 20 days, Acute onset of cough which Direct contact with Most infectious before Treat case with antibiotics for at Highly communicable. Prevent (Whooping Cough) usually 7 to 10 becomes repeated and respiratory discharges the typical cough begins least 14 days. Exclude case for through immunization with days. violent within 1 to 2 weeks and of an infected person by and until approximately first 5 days of appropriate DTaP or DTP vaccine: 4 doses lasts for 1 to 2 months or airborne droplets. 3 weeks after the onset antibiotic treatment. Contacts by 16 months of age with a more. Thick mucus and of cough in untreated should be evaluated for receiving booster dose at 4 to 6 years. vomiting after a coughing cases. After 5 days of antibiotics and vaccine, and for Pertussis vaccine is required spell is characteristic. Young treatment with exclusion recommendations. for child care and school infants and adults may not appropriate antibiotic, attendance until age 7; have the typical inspiratory person is no longer pertussis vaccine is not "whoop." infectious. indicated for children age 7 years and above. POLIOMYELITIS 3 to 35 days, Symptom severity Primarily person to Not accurately known. Exclude case until health officer No wild type polioviruses have usually 7 to 14 ranges from inapparent person spread Cases are probably most approves readmission. been found in the U.S. since days. infection, to mild illness principally thru fecal-oral infectious during the first Susceptible contacts should Every child should (fever, malaise, route, also thru nasal few days before and receive polio vaccine. receive the primary polio headache, vomiting), to or pharyngeal after onset. Virus vaccine series; 3 doses by severe illness (meningi- discharges. remains in throat about 1 16 months of age, with a tis, muscle paralysis, week, and in feces for booster dose at 4 to 6 years. death). 3 to 6 weeks or longer. Polio vaccine is required for child care and school attendance. RABIES Human: Usually Human: Apprehension, Contact with saliva of an Domestic animals: Human exposure: Wash hands Animal bites, scratches, mucous Human rabies is 3 to 8 weeks, headache, fever, malaise, infected animal (dog, For dogs and cats, thoroughly with soap and water. membrane exposures, and an Emergency rarely as short paresis or paralysis, raccoon, etc.) through a usually 3 to 7 days Give post exposure prophylaxis situations where lack of exposure Reportable Disease. as 9 days or as hyrdophobia (fear or water), break in the skin (scratch, before onset of (PEP) promptly when indicated. can not be documented, e.g., bat long as 7 years. delirium, convulsions, and bite) or a mucous clinical signs (rarely over Domestic animal: Confine cat, was in room with a sleeping child, Animal: 3 to 11 death due to respiratory membrane. Person-to- 4 days) and throughout dog, or farm animal that has should be immediately reported to weeks after paralysis. person spread never course of disease. exposed a human and observe Public Health by telephone. PEP exposure (can Animal: Behavior change documented except Wild and exotic for 10 days. If signs of rabies should begin as soon as possible be shorter or (aggression or stupor), through corneal animals: Unknown appear, veterinary examination when exposure occurs. If not longer depending increase in salivation due to transplant. While rare, and laboratory testing is previously vaccinated, give human on location of an inability to swallow, and airborne spread has necessary. rabies immune globulin (HRIG) and bite, type and paralysis of limbs. Death been demonstrated in a Wild and Exotic Animal: Test five doses of human diploid cell amount of virus.) due to respiratory paralysis cave where many bats animal immediately for rabies if rabies vaccine (HDCV). When a usually occurs within 2 to 7 were roosting and in recommended by the local domestic animal is bitten by a wild days after onset. laboratory settings. health department. animal e.g. raccoon, consult with a veterinarian. Cerro Gordo County Department of Public Health (641) Page 8

10 RINGWORM OF 10 to 14 days. Patchy areas of Direct person-to-person Until rash/lesions heal. Infection of the scalp requires Infected children should not SCALP dandruff like scaling and contact or indirect contact oral antifungal therapy, generally share combs, brushes or (Tinea Capitis) hair loss; many separate with contaminated for 4 to 6 weeks as directed by a hair ornaments while being blisters with pus in them surfaces or objects such physician. Children receiving treated. Haircuts or shaving with little hair loss; or a as combs, brushes, treatment may return to child care of the head is not necessary. soft, red swollen area of furniture, fabric, clothing, or school. Examine household, Selenium shampoo used scalp. and hats from infected child care, school and animal twice a week decreases persons or animals. contacts; treat if infected. shedding of fungus. RINGWORM OF 4 to 10 days. Infection involves the Direct person-to-person Until rash/lesions heal. Routine exclusion is not Avoid direct contact with SKIN/BODY face, trunk, or or animal contact or recommended. Most cases are known infected persons (Tinea Corporis) extremities. Rash is indirect contact with treated with topical antifungal and animals. usually circular, slightly contaminated articles medication for about 4 weeks. red with a scaly border such as floors, showers, While being treated, exclude from and may be itchy. and benches. gymnasiums, swimming pools, and activities likely to lead to exposure of others. Examine household, child care, school, and animal contacts; treat if infected. ROTAVIRUS Approximately Diarrhea, usually Contact with infected During acute stage and Frequent hand washing is Virus survives for long 1 to 3 days. preceded by or persons stool by later while viral shedding very important in control and periods on hard surfaces, accompanied by vomiting fecal-oral route. Also continues (around 8 prevention of spread. Should not contaminated water and on and low grade fever. isolated in respiratory days). attend school if symptomatic with hands. It's relatively resistant secretions and diarrhea, fever, or vomiting. to commonly used contaminated water. disinfectants, but is killed by chlorine. Contact PH if an outbreak is suspected. Cerro Gordo County Department of Public Health (641) Page 9

11 RUBELLA* 14 to 21 days, Mild illness with low Contact with droplets or For about 7 days before Exclude for 7 days after onset of Highly communicable. (German Measles) usually 14 to 17 fever, mild rash, usually direct contact with nose and at least 4 days rash. Pregnant women should Immunize all children routinely days. associated with and throat discharges of after onset of rash. check with their doctor if at 12 months with MMR enlargement of nodes on an infected person, and Infants with congenital exposed. Follow health vaccine. Exposed pregnant the back of the neck. A possibly blood or urine; rubella may shed virus department recommendations for women should be evaluated rash is often the first from mother to infant for months after birth. exclusion of contacts who have for their susceptibility to symptom and may during pregnancy. not had rubella vaccine. rubella. Infection during resemble measles, pregnancy, especially in the scarlet fever, or first trimester, results in erythema infectiosum congenital rubella syndrome (fifth disease). Fetal in 24% of cases. Rubella infection may lead to vaccine is required for child spontaneous abortion, care and school attendance. congenital malformations, or defects of organs. SALMONELLA 6-72 hours, Diarrhea, fever, Ingestion of contaminated Several days to several Emphasis on good hand washing. Notify PH if outbreak is spp.* average abdominal cramps, eggs, poultry, weeks (antibiotics may Exclusion from school only suspected. hours. vomiting. unpasteurized milk/juice, prolong excretion). necessary if symptomatic with raw fruits and vegetables. diarrhea, fever, or vomiting. Contact with reptiles. SALMONELLA 3 days to 1 month Fever, headache, chills, Fecal contamination As long as bacilli appear Emphasis on good hand washing. There is a vaccine typhi* usually 8-14 constipation, tiredness, of water supplies or in feces, usually from Symptomatic individuals should be available for S. typhi. Notify days. and muscle aches. street-vended foods. the first week throughout excluded if they have diarrhea, PH if outbreak is suspected. Rare in developed convalescence. 2-5% fever, or vomiting. countries. become carriers. SCABIES 2 to 6 weeks; 1 Rapid onset of red Direct skin-to-skin Until mites and eggs are Treat case with scabicide. Itching may persist after to 4 days in papular rash involving contact, such as holding destroyed, usually 1 to 2 Exclude infested persons from treatment due to allergic reinfestations. the fingers, wrists, hands or sexual contact courses of treatment. school or child care until 24 hours reaction. Secondary bacterial elbows, knees and other through contaminated after start of treatment. House- infections of the skin may skin surfaces. Intense clothes. hold and close contacts should result from scratching. Mites itching, especially at be treated at the same time as the do not transmit any night. A classic burrow patient. Clothing, bedding, and communicable disease. Mites or a demonstrated mite other personal articles should be generally die when away from or ovum are diagnostic. laundered using hot cycles of a host for more than 48 hours. washer and dryer or dry cleaned. Cerro Gordo County Department of Public Health (641) Page 10

12 SHIGELLA* hours, Abdominal cramps, fever Food or water During acute infection Emphasis on good hand washing. Notify PH if an outbreak is average 1-3 and diarrhea. Stool may contaminated with fecal and up to 4 weeks after Anyone symptomatic with suspected. Antibiotics may be days. contain blood and material. Usually person onset of illness. diarrhea, fever, or vomiting should used to shorten the duration mucus. to person spread, fecal- not attend school. and severity of the illness. oral transmission. STREPTOCOCCAL 1 to 3 days, Sudden onset of Person-to-person contact Until 24 hours after Exclude case until 24 hours after Asymptomatic carriage is SORE THROAT, occasionally headache, fever, and with discharge from nose appropriate antibiotic start of antibiotic treatment. common in school children. SCARLET FEVER longer. sore throat. Lymph and throat of a case or treatment is begun; Exclude infected food handlers Outbreaks are uncommon. (Scarlatina) nodes of neck tender carrier. Mild cases and 10 to 21 days in from work until 24 hours after Early recognition and and enlarged. In scarlet carriers are important untreated cases. start of treatment. adequate treatment are fever, streptococcal in the spread of the important to prevent sore throat is disease. May be complications, such as accompanied by a fine foodborne through food rheumatic fever or kidney red "sand paper" rash or milk. disease. most often on neck and chest, lasting 1 to 10 days. When it fades, the skin peels, especially on toes and fingers. TUBERCULOSIS * 2 to 10 weeks Feeling weak or sick; Person-to-person Only patients with Exclude TB case from school and Active TB requires treatment (TB) from infection to weight loss, fever, exposure to TB bacteria active cases of TB work until local health officer with multiple antibiotics over positive PPD skin night sweats, chronic in respiratory airborne are infectious. certifies case to be non 6 to 9 months. Teach test; risk of cough, bloody sputum. droplets from a person infectious. Contacts should be children to cover mouth when active TB with active TB of the investigated according to local coughing. Children with TB are greatest during lungs. health department policy. A child poor transmitters of TB the first 2 years with TB will lead to an bacteria. If positive skin test, after infection, investigation into the source of x-ray needed to rule out but can occur infection such as parents and active TB and evaluation throughout life. child care contacts. needed for TB preventive therapy. 10 to 25% of patients with pulmonary TB may have a negative PPD skin test. Cerro Gordo County Department of Public Health (641) Page 11

13 VANCOMYCIN Extremely Person-to-person Stool, urine, or As long as infection or Proper handwashing and basic Students colonized with VRE RESISTANT variable. by direct contact material from an colonization lasts. infection control measures are should not be excluded from ENTEROCOCCI from an infected site. infected site. Persons that have the most important measures to school. If infection is present (VRE) diarrhea or draining prevent the spread of VRE. and child needs to attend infections are shedding daycare/school, following more bacteria than standard precautions and use someone that is only of barrier methods to prevent colonized. exposure to secretions will assist in preventing transmission. Contact the Cerro Gordo County Department of Public Health for recommendations on dealing with diseases or conditions not addressed above. Cerro Gordo County Department of Public Health (641) Page 12